# Observations on Intrinsic Capacity and Sarcopenia in Healthcare-Seeking Older Adults

## TL;DR

This study finds that older adults with sarcopenia have reduced intrinsic capacity, particularly in locomotion and vitality, suggesting a shared underlying cause.

## Contribution

The study identifies specific domains of intrinsic capacity most affected by sarcopenia in older adults in India.

## Key findings

- Sarcopenic patients had significantly higher impairment in locomotion and vitality domains of intrinsic capacity.
- Twenty percent of the studied older adults were diagnosed with sarcopenia.
- The median intrinsic capacity composite score was higher in sarcopenic patients compared to non-sarcopenic patients.

## Abstract

Introduction

Sarcopenia is a generalized disorder of skeletal muscle associated with adverse outcomes in older adults. With advancing age, the ability to overcome adverse outcomes reduces as measured by reduced intrinsic capacity (IC). Therein lies an underlying pathophysiological relationship between sarcopenia and IC. Our study aimed to explore the association between IC and sarcopenia in healthcare-seeking older adults in India.

Materials and methods

We conducted a cross-sectional study at a tertiary care hospital in New Delhi, India. One hundred and thirty older adults (90 men and 40 women) aged 65 years attended outpatient department services. Sarcopenia was diagnosed as per the Asian Working Group for Sarcopenia (AWGS) 2019 consensus criteria. IC was evaluated as the sum of five domains defined by the World Health Organization (WHO), namely, cognition, sensory (self-reported vision and hearing), locomotion, vitality (nutrition), and psychological. The IC composite score was calculated by summing of scores of all five domains, with a higher score representing lower IC.

Results

The mean age of patients was 70.8±5.8 years. Twenty-six patients (20%) had sarcopenia. Sarcopenic patients were older, less physically active, had a similar incidence of chronic comorbidities, and had significant polypharmacy as compared to non-sarcopenic patients; 73% of total patients had impairment in at least one domain of IC. Cognition, locomotion, sensory, vitality, and psychological domains were impaired in 26%, 48%, 65%, 52% and 44% of total patients, respectively. The median IC composite score was 2 in non-sarcopenic patients, while the sarcopenic patients had a median IC score of 3.5, showing significantly reduced IC. After multivariable analysis, sarcopenic patients had significantly higher impairment in locomotion and vitality domains of IC.

Conclusion

This study showed that lower IC is associated with sarcopenia. Vitality and locomotion domains are strongly associated with sarcopenia. This study is consistent with hypotheses of shared underlying pathophysiology from prior literature, and hence, sarcopenia and IC should be discussed together while diagnosing and managing an older adult in the Integrated Care for Older People (ICOPE) protocol.